APPLICATION FOR TRANSPORTATION SERVICE
Complete this information for all students who ride the school bus to and/or from school including ticket riders. Only one application per household is necessary. Applications and payments of bus fees are required prior to riding the bus. Make payment to Placerville Union School District 2877 Schnell School Rd., Placerville, CA 95667 Attn: Bus Fees
Last Name First Name Date of Birth School Grade Round Trip A.M. Only P.M. Only B/G Only

PARENT/GUARDIAN INFORMATION

Mailing Address:

Home Address:

Local person to call, who may meet child at bus stop or pick up at Transportation Department:

Bus Stop Information: